甲床扩大术的解剖基础及在指端横断性缺损中的应用

Anatomical basis of lengthening nail-bed and application in repair of fingertip traverse defect

目的:介绍一种甲床部分缺失的指端横断性缺损的修复方法。方法:对16例指端横断性缺损,以甲床扩大延长术结合指动脉逆行岛状皮瓣进行修复,皮瓣平均面积约1.5cm×1.0cm。结果:本组皮瓣全部成活。术后随访8～20个月,平均15个月。修复后的指端外观良好,质地柔软,手指无明显触痛,活动功能正常。术后指甲平均延长3.5mm。其中指甲与甲床完全附着12例,附着3/4的4例。结论:甲床扩大延长术结合指动脉侧方岛状皮瓣修复指端,手术简单,指甲美观,是重建指端外形的好方法。

Objective: To introduce a repair method for fingertip traverse defect with nail-bed partial defect. Methods: 16 cases fingertip traverse defect with nail-bed partial defect were treated with digital artery reverse island flap and lengthening nail-bed. The average area of the island flap was about 1.5 cm×1.0 cm. Results: Flaps of all cases survived. After 8 to 20 months of postoperative follow-up, with an average of 15 months, the appearance of fingertip was extremely good, while the texture of flap was soft. The finger had no tenderness and motor disturbance. Finger nail extended about 3.5 mm averagely after operation. Conclusions: Repairing of fingertip traverse defect with digital artery reverse island flap and lengthening nail-bed are easy to operate and can get satisfactory appearance. It is a good method for the reconstruction of fingertip .